Nova Scotia Prediabetes Project: upstream screening and community intervention for prediabetes and undiagnosed type 2 diabetes.

Introduction: Identifying individuals in the prediabetic state may help delay/prevent disease progression to type 2 diabetes mellitus. We explored the feasibility of a household mailing approach for population-based screening of prediabetes and unidentified type 2 diabetes mellitus, developed standard protocol, and developed and implemented community-based lifestyle programs.

Methods: The 16-item Canadian Diabetes Risk Assessment Questionnaire (CANRISK) was mailed to every household in two rural Nova Scotia communities. In total 417 participants aged 40 to 74 years with no prior diagnosis of diabetes self-administered the CANRISK and completed a 2-hour oral glucose tolerance test (OGTT) at a local health care facility. Those with prediabetes were invited to participate in a Prediabetes Lifestyle Program.

Results: Glycemic status was identified as normal, prediabetes or diabetes for 84%, 13% and 3% of participants, respectively. Association between glycemic status and overall CANRISK risk score was statistically significant. Six CANRISK items were significantly associated with glycemic status: body mass index, waist circumference, history of hypertension and hyperglycemia, education and perceived health status. Participants and physicians gave positive feedback on the CANRISK screening process.

Conclusion: The CANRISK holds promise as a population-based screening tool.